Provider Demographics
NPI:1528395332
Name:SCHOOL UNION 69
Entity Type:Organization
Organization Name:SCHOOL UNION 69
Other - Org Name:HOPE ELEMENTARY SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-763-3818
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:ME
Mailing Address - Zip Code:04847-2007
Mailing Address - Country:US
Mailing Address - Phone:207-763-3818
Mailing Address - Fax:207-763-4719
Practice Address - Street 1:445 CAMDEN RD
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:ME
Practice Address - Zip Code:04847-3115
Practice Address - Country:US
Practice Address - Phone:207-763-3818
Practice Address - Fax:207-763-4719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME122110000Medicaid